AB0771 FEMALE GENDER AND STEROID TREATMENT AS MAIN INFLUENCING FACTORS IN THE PERCEPTION OF QUALITY OF LIFE IN ANCA-ASSOCIATED VASCULITIS: FINAL RESULTS FROM THE ITALIAN VERSION OF ANCA-ASSOCIATED VASCULITIS PATIENT-REPORTED OUTCOME (AAV-PRO_ITA) QUESTIONNAIRE
Authors: E. Treppo, M. Isola, M. De Martino, R. Padoan, M. L. Urban, S. Monti, S. Sartorelli, A. Giollo, L. M. Argolini, C. Marvisi, A. Gattamelata, F. Regola, F. Ferro, G. Cassone, F. Motta, A. Berti, E. Conticini, S. Guiducci, M. Matucci-Cerinic, A. Lo Gullo, A. Manfredi, B. Frediani, R. Bortolotti, C. Selmi, C. Baldini, F. Franceschini, F. Conti, G. Emmi, R. Caporali, M. Rossini, L. Dagna, C. Montecucco, F. Schiavon, C. Salvarani, S. De Vita, L. Quartuccio
Journal: Annals of the Rheumatic Diseases (2023)

<h3>Background</h3> The ANCA-associated vasculitis patient-reported outcome (AAV-PRO) questionnaire is a 29-item disease-specific PRO measure for AAV [1]. Originally only available in English, it has been translated into several languages in recent years to spread its use. The Italian version of the AAV-PRO questionnaire (AAV-PRO_ita) was translated in collaboration with Oxford and Bristol University (UK) and, after a preliminarily test on a single-center Italian cohort [2], it was evaluated on a large Italian cohort [3]. <h3>Objectives</h3> To assess the internal consistency, feasibility, and reliability of the AAV-PRO_ita in the multicentric cohort of Italian AAV patients belonging to the Vasculitis Study Group of the Italian Society of Rheumatology. <h3>Methods</h3> The AAV-PRO_ita is describes the following disease domains: (1)organ-specific and systemic symptoms and signs(SSS); (2) physical function(PF); (3)social and emotional impact(SEI). In this study, Italian-speaking AAV patients were recruited from Italian Centres (N=17) with a large experience in the diagnosis and treatment of systemic vasculitis, belonging to the Vasculitis Study Group of the SIR. Inclusion criteria were: a confirmed diagnosis of GPA, MPA, or EGPA; ANCA positivity in at least once occasion or biopsy-proven AAV; and age ≥18 years old. Participants completed the AAV-PRO_ita at three different time-points: baseline, after 5-7 days, and at month 3. <h3>Results</h3> 276 AAV-patients (56.5% women) with a median age of 61 (IQR 51.5-71.6) were recruited and completed the questionnaires. The subtype of AAV was mainly GPA (146, 52.9%), followed by EGPA (77, 27.9%), and MPA (53, 19.2%). Median BVASv3 at baseline was 0 (IQR 0-3), whereas the median BVASv3 at the onset of disease was 13 (IQR 8-18). Participants had a median duration of disease of 62 (IQR 23.8-118.5) months. Patients who experienced at least one relapse, one hospitalization, and one severe infection were 41.7%, 53.3%, and 22.1%, respectively. 81.2% of the patients were on immunosuppressant therapy and 72.1% were still receiving GCs. AAV-PRO_ita questionnaire had good internal consistency (Cronbach's Alpha range 0.81-0.93) and good test-retest reliability (ICCs range 0.93-0.96). Item response rates were high overall (maximum 1.8% missing data), supporting the feasibility of the questionnaire. Concerning the domains of the questionnaire, female AAV patients scored higher (i.e. worse) in all 3 domains, especially in the SEI domain (p-value&lt;0.001). There were also differences between patients on steroid therapy (n=199) and patients without steroid therapy (n=77), in fact, the former had higher scores on all domains, especially in the PF domain (p-value&lt;0.001). Furthermore, patients who had at least one relapse of disease (n=114) had higher scores compared with who had never had one (n=161) on all domains (p-value&lt;0.05). Differently, there were no differences in median scores between younger and older responders and between AAV subtypes. Duration of disease, previous hospitalizations and/or infections, BVASv3 and VDI at baseline did not influence the scores. <h3>Conclusion</h3> The AAV-PRO_ita questionnaire is a new 29-item, disease-specific PRO measure for use in AAV in the Italian language. It is a self-administered Italian questionnaire with good internal consistency, feasibility, and reliability. Research on treatment strategies based on steroid-sparing regimen and spreading awareness of the existence of gender differences in medicine may improve the perceived QoL of AAV patients, reducing the psychosocial impact of the chronic disease. <h3>References</h3> [1]Robson JC et al. <i>Ann Rheum Dis</i> (2018) 77:1157–1164. doi: 10.1136/annrheumdis-2017-212713 [2]Treppo E et Al. <i>Annals of the Rheumatic Diseases</i> (2021) 80:1224–1224. doi: 10.1136/annrheumdis-2021-eular.2123 [3]Treppo E et Al. <i>Annals of the Rheumatic Diseases</i> (2022) 81:1440–1440. doi: 10.1136/annrheumdis-2022-eular.3164 <h3>Acknowledgements</h3> We thank the Italian Vasculitis Study Group. <h3>Disclosure of Interests</h3> None Declared.